Heavily Calcified LM Trifurcation With Hemodynamic Support

Case submitted by Jonathan Hill, King’s College

Summary: Unprotected left main (LM) trifurcation with heavy calcium throughout LM, left anterior descending artery (LAD), left circumflex artery (LCX), and at ostia of trifurcation; hemodynamic support with temporary pump; Shockwave IVL administered along LAD, LCX, LM and at the ostia of LCX, LAD, and Ramus; drug-eluting stents (DES) placed in LM and all three vessels with good expansion and apposition (demonstrated with OCT).